Vesicointestinal, Vesicocutaneous Fistula and Tubal Invasion Secondary to Bladder Adenocarcinoma: A Case Report
1Department of Urology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
2Department of General Surgery, Erciyes University Medical Faculty, Kayseri, Turkey
J Clin Pract Res 2008; 30(1): 44-47
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Abstract

Adenocarcinomas constitute less than 2% of primary bladder cancers. Seventy-five year-old female patient presented to the urology clinic with the complaint of urinary flow from suprapubic region which has been continuing for the last 1 month. Endoscopy revealed a vesicocutaneous fistula and a vesicointestinal fistula of approximately 2cm diameter. Lower abdominal midline incision was applied for laparotomy. Bladder was observed to show an advanced level of adherence to adjacent tissues. Ovaries were of cystic appearance and uterus was adhered to bladder. Frozen sections were obtained from the portions where uterus showed adherence to bladder and ovaries. Results of the frozen section analysis suggested malignant invasion. Thus eventually; cystectomy, bilateral salpingooophorectomy, hysterectomy, sigmoidectomy, Hartmann colostomy, and ureterocutaneostomy were carried out on the patient. She was deceased on the 10th postoperative day due to cardiopulmonary arrest. Definitive pathological result was reported as bladder adenocarcinoma and invasion.


Mesane Adenokarsinomuna Sekonder Vezikointestinal, Vezikokutanöz Fistül ve Tubal İnvazyon: Olgu Sunumu
1Department of Urology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
2Department of General Surgery, Erciyes University Medical Faculty, Kayseri, Turkey
Journal of Clinical Practice and Research 2008; 1(30): 44-47

Adenokarsinomlar primer mesane kanserlerinin yüzde ikisinden azını oluşturur. Yetmiş beş yaşında bayan hasta, üroloji kliniğine suprapubik bölgeden bir aydır idrar gelmesi şikayetiyle başvurdu. Yapılan endoskopide yaklaşık 2 cm'lik vezikointestinal fistül ve vezikokutanös fistül saptandı. Laparotomide göbek altı orta hat insizyonla girildi. Mesanenin etraf dokulara ileri derecede yapışık olduğu izlendi. Overler kistik görünümdeydi, uterus mesaneye yapışıktı. Uterusun mesaneye ve overlere yapışık olduğu yerden frozen çalışıldı. Frozen sonucu malign invazyon olarak değerlendirildi. Bunun üzerine hastaya sistektomi, iki taraflı salpingoooferektomi, histerektomi, sigmoidektomi, Hartmann kolostomi ve üreterokutaneostomi yapıldı. Olgu operason sonrası onuncu gününde kardiyopulmoner arrest sonucu kaybedildi. Kesin patoloji sonucu mesane adenokanseri ve invazyon olarak raporedildi.